Surgical treatment of isolated aseptic acetabular loosening of the hip joint
Heading: Traumatology and Orthopedics Article type: Case report
Authors: Zvereva К.Р., Markov D.A., Reshetnikov A.N.
Organization:
Aseptic acetabular loosening is one of the most common complications of primary hip arthroplasty Its treatment is possible in the volume of replacement of only the endoprosthesis cup with the preservation of a stable correctly oriented femoral component. The sequence of actions consists of provision of access to the acetabulum component and its replacement, after which the necessary offset is selected by changing the size of the head and installing a new pair of friction. Currently, the vast majority of the installed heads during the primary and revision hip replacement have a standard size forthe cone of the femoral component 12/14mm. According to the observations, in 3% of cases, there are femoral components with non-standard cone sizes 11/13 mm, usually established 7-8 years ago. The absence of heads forthe necessary cone leads to the need to replace the stable correctly oriented femoral component, which is accompanied by an increase in the time of intervention, the volume of intraoperative blood loss and the risk of intraopera-tive peri-prosthetic fracture. We represent the clinical case of a 75-year-old patient with a dislocation of the acetabular component and a stable correctly oriented femoral component, which during the audit intervention due to the lack of heads for an irregular cone size, total replacement of the components was made.
Bibliography:
1. Elganzoury I, Bassiony AA. Early Results of Trabecular Metal Augment for Acetabular Reconstruction in Revision Hip Arthroplasty. Acta Orthop Belg 2013; (79): 530-535
2. Lim S, Lee Y, Lim B, et al. Re-revision of failed revision Total Hip Arthroplasty acetabular components. Acta Orthop Belg 2014; (80): 357-364
3. Norkin IA, Bakhteeva NH, Kireev SI, et al. Traumatology and Orthopedics (2nd edition, expanded). Saratov, 2015; 220 p.
4. Nikolaev IA. Technology replacement of bone defects in the revision of the acetabular component of the hip joint: PhD diss. Moscow, 2015; 145 p.
5. Abrahams JM, Kim YS, Callary SA, et al. The diagnostic performance of radiographic criteria to detect aseptic acetabular component loosening after revision total hip arthroplasty. Bone Joint J 2017; (99-B): 458-64
6. Friedrich MJ, Wimmer MD, Schmolders J, et al. RANK-ligand and osteoprotegerin as biomarkers in the differentiation between periprosthetic joint infection and aseptic prosthesis loosening. World J Orthop. 2017; 8 (4): 342-349
7. Lis K, Pater A, Nowacki W, et al. Osteoprotegerin, sRANKL and sRANKL /OPG ratio in pseudosynovial fluid from patients with aseptic loosening of total hip prosthesis. Folia Medica Copernicana 2014; 2 (1):26-30
8. Karjakina EV, Persova EA. Aseptic Instability of the Hip Endoprothesis in Patients with Coxarthrosis. Saratov Journal of Medical Scientific Research 2009; 5 (3): 375-378
9. Piolanti N, Andreani L, Parchi PD, et al. Clinical and Radiological Results over the Medium Term of Isolated Acetabular Revision. The Scientific World Journal 2014; Article ID 148592
10. Katsutoshi Hara, Nobuhiro Kaku, Tomonori Tabata, et al. Isolated Acetabular Revision for Failed Bipolar Hemiarthroplasty Wthout Removal of a Well-Fixed Femoral Component. Orthopaedic Proceedings 2013; 95-B (15191) ISSN 1358-992X
11. Lawless BM, Healy WL, Sanjeev S, etal. Outcomes of Isolated Acetabular Revision. Clin Orthop Relat Res 2010; 468 (2): 472-479.
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